Plastic Surgery, The Journey

Plastic Surgery, The Journey

The term “Plastic” used for Plastic Surgery comes from the Greek word “Plastikos” which means: To mold, to create, to reconstruct, to shape, to form…

The birth place of plastic surgery is in ancient India. There are historic records of reconstructive plastic surgery being performed in ancient India around 600 BC. “Sushruta” has been quoted to have done the first nose reconstructions, for individuals who had lost their nose in battle or as a punishment. Later the Romans also have been credited for performing nasal and facial reconstruction. There is not a great deal of information available about these early methods of nasal reconstruction as they were really kept as a trade secret in the families and passed from father to son for fiscal reasons.

As a Plastic Surgeon in the 21st century, with all the technology and anaesthetics available at my disposal, I can only read these tales with admiration and some disbelief and wonder how they did it or how much pain the patients had to endure.

The Grandfather of modern plastic surgery is “Gasparo Tagliacozzi” the Italian 16th century physician, who experimented with reconstructive flaps to cover facial or other wounds, after noting the need for plastic surgery due to duels, street brawls, ets… For Tagliacozzi, Plastic Surgery was to restore and make whole those parts that nature or ill-fortune has taken away, not only for the delight of the eye but also to lift up the spirit and help the mind of the afflicted.

If Tagliacozzi is the grandfather of plastic surgery, then the fathers of Modern Plastic Surgery are really “Sir Harold Gillies and Sir Archie McIndoe”. They were both New Zealanders (cousins) working in the UK around War World 1 and WW2. They worked on the RAAF Pilots with bad facial and burns injuries. Both pioneered many of the current plastic surgery techniques for Facial trauma, Burns Surgery and other field of plastic surgery. Although they are most famous for their reconstructive work on the service-men, they also had a striving private practice, and were consulted by many of the famous people of the era. Gillies has been accredited with performing one of the first sex-change operations both from male to female and vice versa. Both Gillies and McIndoe designed different surgical forceps that carry their name and are still widely used by surgeons worldwide.

Modern Plastic Surgery is a vast and fascinating field of Surgery. It encompasses more than just Cosmetic Surgery, which is what is promoted by the TV programs such as “Nip /Tuck”, “Extreme Makeover”… Plastic Surgeons look after major Burns, Skin cancers, Hand surgery(both elective and traumatic), Facial trauma, Reconstructive surgery, cleft lip and palate, Craniofacial disease, Microsurgery and of course Cosmetic Surgery. It is not surprising then that Plastic Surgeons need to call upon meticulous and precise surgical techniques as well as an in-depth knowledge of the anatomy of the whole body.

I remember my Final fellowship exam (to become a Plastic Surgeon), which is conducted by the Royal Australasian College of Surgeons for all the Surgical specialties (Neurosurgery, Urology, Cardiac Surgery, Ear Nose & Throat, orthopaedic etc.) examined on the same day. In the Anatomy exam, each of the other specialties just had one or two section of the human body that they needed to know, and were examined on. In plastic surgery, however, my examiner started with questions about the human skull and where the muscles attach to it, then moved gradually down the body until we reached the foot where I was asked about the blood supply to the various muscles in the foot!

Plastic Surgery requires attention to minute details, ultimate technical skills and knowledge, as well as an artistic flare. In all its forms it can change the course of a person’s life by giving him or her more self-confidence and enhance their morale.

To me as was to Tagliacozzi Plastic Surgery is one way humankind seeks improvement of self both physically and emotionally.

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